Incidence, Presentation, Characteristics and Short Term Outcomes of Hospitalized Pregnant Women Confirmed SARS-COV-2 Positive

Abstract

To report the incidence, presentation, characteristics and outcomes of a cohort of hospitalized pregnant women who had tested positive for SARS-2, whether or not they had demonstrated signs of Coronavirus Disease-19 (2019-nCov, or Covid-19, ICD-10 U07.1). Material and Methods. The study includes pregnant women, 18 years old and older, who were hospitalized for evaluation or delivery and who had tested positive for SARS-CoV-2 via NP sampling. All were followed by RT PCR and NAA determination between March and December of 2020. Universal testing for SARS-CoV-2 was used throughout the study period. Maternal history and physical screening were conducted upon admission to detect any of the known variables of Covid-19, such as: fatigue, fever (38 C), shortness of breath, and cough. Chest imaging was obtained when indicated. The screening process included domestic or international travel. Additional information collected on 100% of the patients included: maternal ethnicity, body mass index, and 5-digit zip code of maternal residence. Neonates (NN) from SARS-2 positive mothers at delivery admission were tested following the Neonatology service protocol, at age 24 and 48 hours. Additional testing was performed prior to NN discharge when indicated. Results. Of the 3,109 pregnant women who were hospitalized and tested during the study period, 4.3% were reported SARS-2 positive. Of these patients, 13.6% were symptomatic for Covid-19 upon admission; 54% showed a comorbidity; 61% were obese; and one patient needed mechanical ventilation. Table 1 summarizes the cohort characteristics. Table 2 shows the characteristics of the symptomatic women and their clinical course. Conclusion. Our report describes a pregnant patient cohort that had experienced mild to moderate Covid-19 disease. Conflicting studies postulated that pregnant women exposed to SARS-CoV-2 may suffer more serious adverse effects than their non-pregnant counterparts. In view of the wide spectrum of clinical events and the variable severity reported in association with Covid-19 in pregnancy, we believe that quality big data would be beneficial. We therefore recommend strict identification of maternal ethnicity, comorbidities, timing, acuity and severity of the disease. Moreover, health care culture with accurate harmonization of clinical findings and treatments via widespread collaborative efforts, with timely reporting, may assist in understanding the variable pathophysiology of the novel SARS-CoV-2, including its variants, and their conflicting effects on pregnancy.